The effect of bilateral tubal ligation on menopause age and symptoms

Abstract

Background/Aim: Bilateral tubal ligation (BTL) is an effective and safe method for family planning; however, the blood supply of the ovaries may be affected during the procedure. There is suspicion that women may enter menopause early once BTL is performed. Although some studies in the literature have evaluated bilateral tubal ligation’s effect on ovarian reserves and function, studies investigating its effect on menopause age and symptoms are lacking. The aim of this study was to investigate the effect of bilateral tubal ligation on menopause age and symptoms, eliminate women's hesitations, and guide the clinicians. Methods: Two hundred postmenopausal women with no comorbidities which may affect the ovarian reserve and menopause symptom severity were included in this case-control study. One hundred women who had undergone bilateral tubal ligation constituted the bilateral tubal ligation (BTL) group, while 100 women who had not undergone any surgery, including bilateral tubal ligation, and who had not received medical treatment and naturally gone through menopause, constituted the control group. Data of all patients regarding menopause age, obstetric history, and educational status were collected. The ‘Menopause Rating Scale’ was applied to the groups to assess the severity of menopause symptoms. Bilateral tubal ligation age was recorded for the study group. The results were compared using statistical methods. Results: The mean menopause ages of the bilateral tubal ligation and control groups were 48.30 (3.5) and 47.67 (4.3) years, respectively (P=0.250). The two groups were similar in terms of somatic (P=0.744), psychological (P=0.930), and urogenital (P=0.477) menopause symptoms. The mean age at which bilateral tubal ligation was performed in the bilateral tubal ligation group was 37.33 (4.6) years. Conclusion: The bilateral tubal ligation procedure did not affect menopause age or the severity of menopause symptoms.

Keywords

• Bilateral tubal ligation
• Contraception
• Menopause age
• Menopause symptoms

References

1. 1. De Franciscis P, Colacurci N, Riemma G, Conte A, Pittana E, Guida M, et al. Nutraceutical Approach to Menopausal Complaints. Medicina (Kaunas). 2019;55(9):554.
2. 2. World health statistics Overview 2019 https://apps.who.int/iris/bitstream/handle/10665/311696/WHO-DAD-2019.1-eng.pdf?ua=1
3. 3. Türkiye İstatistik Kurumu 2014 www.tuik.gov.tr/PreHaberBultenleri. Access time: 28 May 2019
4. 4. Versi E, Harvey MA, Cardozo L, Brincat M, Studd JW. Urogenital prolapse and atrophy at menopause: a prevalence study. Int Urogynecol J Pelvic Floor Dysfunct. 2001;12(2):107-10.
5. 5. Rabban JT, Garg K, Crawford B, Chen LM, Zaloudek CJ. Early detection of high-grade tubal serous carcinoma in women at low risk for hereditary breast and ovarian cancer syndrome by systematic examination of fallopian tubes incidentally removed during benign surgery. Am J Surg Pathol. 2014;38(6):729-42.
6. 6. Potthoff P, Heinemann LA, Schneider HP, Rosemeier HP, Hauser GA. Menopause-Rating-Skala (MRS II): Methodische Standardisierung in der deutschen Bevölkerung [The Menopause Rating Scale (MRS II): methodological standardization in the German population]. Zentralbl Gynakol. 2000;122(5):280-6.
7. 7. Can-Gürkan Ö. Menopoz Semptomlarını Değerlendirme Ölçeği'nin Türkçe formunun güvenirlik ve geçerliliği. Hemşirelik Forumu 2005;30-35
8. 8. Gürbüz T, Dokuzeylül Güngör N, Tanrıdan Okçu N , Yurci A . Effects of contraception methods on female sexual function and quality of life. Journal of Surgery and Medicine 2020;4(12):1231-1235

9. 9. Ainsworth AJ, Baumgarten SC, Bakkum-Gamez JN, Vachon CM, Weaver AL, Laughlin-Tommaso SK. Tubal Ligation and Age at Natural Menopause. Obstet Gynecol. 2019;133(6):1247–1254.
10. 10. Depmann M, Eijkemans MJC, Broer SL, Scheffer GJ, van Rooij IAJ, Laven JSE, et al. Does anti-Mullerian hormone predict menopause in the general population? Results of a prospective ongoing cohort study. Human Reprod. 2016;31(7):1579–87.
11. 11. Moslehi N, Mirmiran P, Tehrani FR, Azizi F. Current Evidence on Associations of Nutritional Factors with Ovarian Reserve and Timing of Menopause: A Systematic Review. Adv Nutr. 2017;8(4):597-612.
12. 12. Sezik M, Ozkaya O, Demir F, Sezik HT, Kaya H. Total salpingectomy during abdominal hysterectomy: effects on ovarian reserve and ovarian stromal blood flow. J Obstet Gynaecol Res. 2007;33(6):863-9.
13. 13. Findley AD, Siedhoff MT, Hobbs KA, Steege JF, Carey ET, McCall CA, et al. Short-term effects of salpingectomy during laparoscopic hysterectomy on ovarian reserve: a pilot randomized controlled trial. Fertil Steril. 2013;100(6):1704-8.
14. 14. Song T, Kim MK, Kim ML, Jung YW, Yun BS, Seong SJ, et al. Impact of opportunistic salpingectomy on anti‐Müllerian hormone in patients undergoing laparoscopic hysterectomy: a multicentre randomised controlled trial. BJOG. 2017;124(2):314-20.
15. 15. Herman HG, Gluck O, Keidar R, Kerner R, Kovo M, Levran D, et al. Ovarian reserve following cesarean section with salpingectomy vs tubal ligation: a randomized trial. Am J Obst Gynecol. 217(4):472.e1-472.e6
16. 16. Venturella R, Morelli M, Lico D, et al. Wide excision of soft tissues adjacent to the ovary and fallopian tube does not impair the ovarian reserve in women undergoing prophylactic bilateral salpingectomy: results from a randomized, controlled trial. Fertil Steril. 2015;104(5):1332-9.
17. 17. Kotlyar A, Gingold J, Shue S, Falcone T. The effect of salpingectomy on ovarian function. Minim Invasive Gynecol. 2017;24(4):563-8.
18. 18. Gemici A, Şükür YE, Tülek F, Taşkın S, Atabekoğlu CS. Post-partum tubal ligation at time of cesarean delivery or via laparoscopy as an interval sterilization has similar effects on ovarian reserve. J Turk Ger Gynecol Assoc. 2020;21(1):24-8.
19. 19. Kaya C, Turgut H, Cengiz H, Turan A, Ekin M, Yaşar L. The effect of tubal sterilization with the Pomeroy technique and bipolar electrocauterization on the ovarian reserve and serum anti-Müllerian hormone levels in a rat model. Eur J Obstet Gynecol Reprod Biol. 2015;185:108-13
20. 20. Yazici G, Arslan M, Pata O, Oz U, Aban M. Ovarian function and vascular resistance after tubal sterilization. J Reprod Med. 2004;49(5):379-83.
21. 21. Dede FS, Akyuz O, Dilbaz B, Caliskan E, Haberal A. Color doppler flow analysis of uterine and ovarian arteries before and after tubal sterilization: electrocautery versus pomeroy. Gynecol Obstet Invest. 2006;61(1):45-8.
22. 22. Kelekci S, Yorgancioglu Z, Yilmaz B, Yasar L, Savan K, Sonmez S, Kart C. Effect of tubal ligation on ovarian reserve and the ovarian stromal blood supply. Aust N Z J Obstet Gynaecol. 2004;44(5):449-51.
23. 23. Bekiroğlu N, Gürbüz A, Konyalıoğlu R, Ayas S, Alkan A, Eren S. Menopoz Semptomlarını Değerlendirme Ölçeği (MSDÖ), Kupperman Menopoz Ölçeği (KMÖ) ve Nothingam Sağlık Profili (NSP) ölçeklerinin güvenirlik ve yanıtlama etki büyüklüklerinin yeni menopozlu hastalarda karşılaştırılması. Zeynep Kamil Tıp Bülteni 2008;39(1):11-5.
24. 24. Alpaslan M. The effect of menopausal symptoms on daily living activities [dissertation]. Ordu University 2018.
25. 25. Schneider HPG, Birkhäuser M. Quality of life in climacteric women. Climacteric. 2017;20(3):187-94.
26. 26. Blumel JE, Castelo-Branco C, Binfa L, Gramegna G, Tacla X, Aracena B, et al. Quality of life after the menopause: a population study. Maturitas. 2000;34(1):17-23.
27. 27. Williams RE, Levine KB, Kalilani L, Lewis J, Clark RV. Menopause-specific questionnaire assessment in US population-based study shows negative impact on health-related quality of life. Maturitas. 2009;62(2):153-9.